Bedaquiline Correlation to QT Interval Prolongation in DR-TB Patients

Abstract

Introduction: Drug-Resistant Tuberculosis (DR-TB) requires adequate treatment. Bedaquiline is a priority medicine in the treatment regimen of DR-TB. One of the adverse events is QT interval prolongation, which can increase the risk of torsade de pointes (TdP) and lead to death. DR-TB patient screening before starting the treatment and monitoring QT interval during the treatment should be performed. This study aimed to determine Bedaquiline correlation to QT interval prolongation in DR-TB patients. Methods: This was a retrospective study using an observational design by viewing medical records of DR-TB patients who underwent treatment from January 2019 to March 2022. Results: This study involved 46 DR-TB patients with a regimen of Bedaquiline. The comparison of Baseline QT intervals before and after one month of therapy showed QT interval prolongation (457.1 ± 18.2 ms and 443.8 ± 10.2 ms; p < 0.001). The comparison of QT intervals before the therapy and six months after the therapy showed prolongation QT intervals (443.8 ± 10.2 ms and 458.4 ± 23.7 ms; p < 0.001). QT intervals after one month of therapy compared to six months after the therapy showed insignificant slight prolongation (457.1 ± 18.2 ms and 458.4 ± 23.7 ms; p = 0.587). Conclusion: QT interval prolongation occurred in DR-TB patients who received treatment using Bedaquiline regimen. It was seen significantly between baseline QT interval compared to after receiving the therapy for one month and baseline QT interval compared to after receiving the therapy for six months.

Factors Associated with Unsuccessful Treatment of Bedaquiline and or Delamanid Based Regimens in Multidrug-Resistant Tuberculosis: A Review

“…The administration of bedaquiline and or delamanid as part of an all-oral regimen improve success treatment (culture conversion) and minimize side effects, such as hearing loss, hearing disorders, and renal dysfunction, related to the second line injectable drugs (Yang et al, 2017). Several studies have reported that adding bedaquiline and or delamanid to DR-TB regimens effectively increase a culture conversion rate at 6 months or after treatment completion (Kempker et al, 2020;Maretbayeva et al, 2021) Regimens containing bedaquiline to treat DR-TB is relatively safe with no cases of QTc interval more than 500 ms during six months of treatment as reported by Primadana et al (Primadana et al, 2022). On the other hand, beyond its bactericidal activity, delamanid alter the function of host immune cell.…”

Bedaquiline Effect Towards QT Interval in Drug Resistant Tuberculosis (DR-TB): A Systematic Review

“…The mean QT interval value after treatment with Bedaquiline in each article was rated as safe at <450ms. Only one article by Vandu et al 12 , 2022 which in their research found a mean QT interval value of 458.4ms, this according to the degree of QT interval display is considered as QT prolongation degree 1. When looking at the column of QT Interval changes from baseline also in each study can be said to be safe, no study found a mean increase in QT interval from baseline ≥60ms.…”